Galen on bloodletting: a study of the origins, development and validity of his opinions, with a translation of the three works

instance, whose latest work Dead Ringers follows in detail the surgical experiments of increasingly mad twin gynaecologists, is a very disturbing meditation on the medical profession and its handling of the body, and deserves "careful study". But this checklist is too slackly conceived and written to suggest the real intellectual challenge of making the connections it presumes are desirable. What is needed is a series of sharply focused, fully informed and thoughtful pieces of criticism about the complex interrelation between an industry which is also an art and a science which is both a humane calling and a capitalist empire. PETER BRAIN, Galen on bloodletting: a study of the origins, development and validity of his opinions, with a translation of the three works, This is a curious and idiosyncratic book. Its organization and scholarly methodology should be greeted with some reservation, but at the same time the work is important and stimulating. It begins with a chapter summarizing the medical system of Galen, the Greek from Pergamon who rose to great influence in Rome and determined the course of Western medicine for a millenium and a half. The Galenic system was based on a purposive view of nature; carefully observed anatomy; a humoral physiology that explained health as balance or crasis and disease as dyscrasia; a particular concern with conditions called plethora; and beliefs in the value of cure by opposites and venesection. The three works of Galen devoted to bloodletting are translated in the next chapters, 2, 3, and 4. They (using Brain's translated titles) are 'Galen's Book on Venesection against Erasistratus', an early (ca. AD 163) lecture, a rather disorganized attack on Erasistratus for his therapy of purgation and starvation rather than bloodletting; and 'Galen's Book on Venesection against the Erasistrateans in Rome', a work Brain dates ca. AD 175-80, which attacks both Erasistratus, who eschewed phlebotomy, and the Roman Erasistrateans, who misrepresented Erasistratus and should be condemned for using venesection excessively and with no rational basis. A third, less tendentious treatise, 'Galen's Book on Treatment by Venesection', from the 190s, addresses the value of phlebotomy for evacuation; two kinds of plethora and the putrefaction of humours; those cases where bloodletting is to be avoided; prophylactic phlebotomy; contraindications to the use of venesection (lack of strength being the most important); the revulsive use of the therapy; and appropriate veins for specific disorders. Chapter 5 is on the relation …